| NPI | 1992358139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLANDO GIL MENDOZA Administrator And Licensee 502-544-3068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |